United Health Care Tele Doctor – Why are doctors now charging patients for certain phone calls that used to be free? Highlights – Health News As part of their social distancing policies, elected leaders have proposed that telephone and video medical appointments be covered by health insurance. So why are some patients paying $70 per virtual visit?
Despite recent insurance policy changes, some patients say doctors and insurers charge them upfront for video visits and phone calls — not just a co-pay, but sometimes the full cost of the visit, even if it’s covered by insurance. Sesame/Getty Images hide caption
United Health Care Tele Doctor
Despite recent insurance policy changes, some patients say doctors and insurers charge them upfront for video visits and phone calls — not just a co-pay, but sometimes the full cost of the visit, even if it’s covered by insurance.
Unitedhealthcare, Houston Methodist Physicians Extend Contract Amid Coronavirus
Karen Taylor had been coughing for weeks when she decided to see a doctor in early April. The number of COVID-19 cases had just passed 5,000 in Texas, where he lives.
Cigna, his health insurer, said it would waive out-of-pocket costs for telehealth patients seeking a coronavirus screening via video conference. So Taylor, the sales manager, talked to her doctor via Internet video call.
The medical office charged him $70. He protested. But “they said: “No, it applies to your deductible and you have to pay the full $70,” she says.
Policymakers and insurance companies across the United States say they are removing co-pays, deductibles and other barriers to telemedicine for patients who are confined to their homes and need to see a doctor for whatever reason.
What Is Telepsychiatry?
“We encourage people to use telemedicine,” New York Gov. Andrew Cuomo said last month after ordering insurers to eliminate fees typically charged to patients at the time of a doctor’s visit for telehealth sessions.
But in a fragmented health care system that includes dozens of insurers, 50 state regulators and thousands of independent practices, the transition to free telemedicine for patients is going far less smoothly than speeches and press releases suggest. In some cases, doctors pay for free phone calls.
Patients say doctors and insurers charge them up front for video calls and phone calls, and not just pay co-pays, but sometimes the full cost of the visit, even if it’s covered by insurance.
Despite promises from politicians, insurers said they were unable to immediately eliminate telehealth fees for millions of members who carry their cards but get coverage through self-insured employers. Telehealth executives say insurers have been slow to update their software and policies.
Game Changing’ Virtual Health Care Saves Soldier’s Life
“Most of the insurers who said they weren’t going to charge co-pays for telemedicine, they haven’t,” said George Favvas, CEO of Circle Medical, a San Francisco company that provides family medicine and other primary care. live broadcast “It’s starting to hit us right now.”
One problem is that insurers have waived telehealth fees and other cost-sharing for in-network doctors only. Another is that Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare and other telehealth promoters have little power to change telemedicine benefits for self-insured employers whose claims they process.
Such programs cover more than 100 million Americans, more than the number of beneficiaries covered by Medicare for the elderly or Medicaid for low-income families. All four insurance giants say expanded telehealth benefits don’t necessarily apply to such coverages. Governors or state insurance regulators cannot force these federally regulated programs to improve telehealth coverage.
Many employer plans are beginning to eliminate cost-sharing, such as copayments and deductibles, now that federal regulators have loosened rules for some types of plans to improve telehealth benefits, said Brian Marcotte, executive director of the National Health Business Group, a coalition. large, mostly self-insured employers;
How Telemedicine Is Transforming Health Care
For many doctors, business and bills have declined due to the coronavirus shutdown. Despite the new rules, many practices may want to collect telehealth revenue directly from patients rather than waiting for insurance companies to pay, said Sabrina Corlette, a research professor and co-director of Georgetown University’s Center for Health Insurance Reform.
“Many providers may not have agreements with the programs they work with to provide telemedicine services,” he says. “So these providers are protected up front by either asking for full payment or getting a co-payment.”
David DeKeyser, a marketing strategist in Brooklyn, New York, sought medical advice via video after coming in contact with someone who attended an event where the coronavirus was detected. The office charged her debit card $280, not just cash on delivery, without notifying her.
“It was a payday for me,” DeKeyser says. a week earlier and the charge could have triggered a bank overdraft. He says an email exchange reversed the bill.
Infographic: Average Wait Times To See A Doctor
With wider adoption, telehealth calls suddenly became an important and lucrative potential source of income for doctors. Medicare and some commercial insurers have said they will pay the same rate for video calls as for office visits.
Some doctors charge for phone calls that were once considered an incidental and unpaid part of the previous office visit. Blue Cross plans in Massachusetts, Wyoming, Alabama and North Carolina pay for patient phone visits, according to American Health Insurance Plans, a lobbying group.
North Carolina teacher Kathryn Parisian says what seemed like a frequent follow-up with her specialist turned into an $80 co-pay telehealth consultation last month.
“What would be considered a phone call, they’re now billing as telemedicine,” he says. “The doctor wouldn’t call me without charging me.”
How Telehealth Is Revolutionizing Healthcare
According to multiple accounts, the number of doctor appointments has skyrocketed since the Department of Health and Human Services announced in mid-March that it would “take necessary steps to expand Americans’ access to telehealth services.”
Medicare has expanded benefits to pay for most telemedicine nationwide, not just for patients in rural areas and other limited circumstances, HHS said. The plan also temporarily stopped requiring doctors to charge patients a co-pay at the time of the visit.
Meanwhile, the CARES Act, passed by Congress last month to address the COVID-19 emergency, allows high-deductible private health insurance to make an exception for telehealth when it comes to cost-sharing. Such plans can now pay for video doctor visits even if patients have not paid the deductible.
Dozens of private health insurers listed by AHIP say they have eliminated patient fees and other cost-sharing for telemedicine. Cigna, however, only waived some of the costs — the cost of telehealth appointments related to COVID-19 screening. Cigna did not respond to requests for comment.
On Demand Telehealth Is Booming Even As A Fierce Competitor Remains: The Doctor’s Office
Teladoc Health, a large publicly traded telemedicine company, says it has doubled its volume to 20,000 medical visits a day since the start of March. Its share price has also almost doubled since January 1.
With such dramatic growth, it’s no wonder insurers and doctors are struggling to keep up, says Circle Medical CEO Favvas.
“It will be an imperfect process for some time,” he says. “It’s understandable, given that things are moving so quickly.”
Abby Van Sickle, a reporter from California, wanted her child’s scheduled wellness visit to be done remotely because she was worried about visiting the doctor’s office during the pandemic. Her insurer, UnitedHealthcare, wouldn’t pay, the pediatrician told her. Mother and child should have gone inside.
Unitedhealth Chases 10,000 More Doctors For Biggest U.s. Network
“It seems like such an unnecessary risk to take,” says Van Sickle. “If we can’t make health visits, we’re certainly not alone.”
A UnitedHealthcare representative says there was a misunderstanding and that the child’s remote visit will be covered without asking VanSickle for a copy.
New York medical anthropologist Jacqueline Grace Lacey had a similar problem. He had to renew the prescription a few weeks after Cuomo ordered insurers to waive the patient share of telehealth appointment costs.
She was told by the office that she would have to come in for a visit or make an appointment with telemedicine. The recordist received a $50 “administrative fee” that he had to pay up front, he says, five times what he would have been charged for the session in person.
The Promise Of Digital Health: Then, Now, And The Future
“I wasn’t going to go to a dispensary and potentially expose people just to fill my monthly prescription,” he says.
Patients should check with their insurer before any telehealth visit to make sure telemedicine is covered by their health policy, Corlette says. If your employer’s plan does not pay for telemedicine or requires a co-pay, contact your company’s human resources department. A company can change this policy if it is self-insured, as most large employers are.
“If you know colleagues in the same boat, encourage them to ask HR as well,” she says. “HR can pay more attention if the request comes from multiple sources.”
Is a noofit, editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente. Cold and flu season is here, which means it’s time to get your flu shot and stock up on your health essentials.
Access To Telemedicine Is Hardest For Those Who Need It Most
Last flu season, over